The Psychological Impact of the COVID-19 Pandemic on Dentists in Germany

Challenges and resilience of Taiwan's oral health care system after Covid-19 pandemic

This paper examines the resilience of Taiwan's oral healthcare system in response to COVID-19, focusing on pre-pandemic conditions, pandemic impacts, and policy recommendations for future resilience. In Taiwan, oral diseases were prevalent, with 80.48% of adults affected by periodontitis in 2016, and 65.43% of 5-year-old children experiencing dental caries. Taiwan's National Health Insurance (NHI) covers over 99% of the population, providing comprehensive dental care. The global budget (GB) payment system, implemented in 1998, ensured financial stability. During the pandemic, dental visits in Taiwan decreased by 5.1% in 2021 compared to 2019. Despite reduced visits, the GB system maintained financial stability, mitigating financial impacts on healthcare institutions. The pandemic generally negatively affected healthcare workers' well-being, increasing resignation intentions. However, the number of practicing dentists in Taiwan remained stable from 2016 to 2022, with slight increases. Urban-rural disparities persisted, and workplace transitions increased, indicating greater mobility among dental professionals. To enhance resilience, the following recommendations are proposed: 1. Strengthen hierarchy of oral healthcare system: Balance dental resources across regions, and improve referrals between hospital and clinics; 2. Provide integrated patient-centered care: Integrate oral health into disease prevention and offer comprehensive services across all stages of life; 3. Integrate digital technology: Promote teledentistry and leverage Taiwan's strengths in information and communication technology (ICT).

Factors Affecting Psychological Well-Being, Depression, Anxiety, and Stress Among Dental Students in Delhi and the National Capital Region: A Cross-Sectional Study

Introduction Research has shown that mental health issues are prevalent among university students and healthcare professionals. Dental practitioners are particularly at risk due to the demanding nature of their profession. Our study aims to survey dental students and faculty to assess their psychological well-being and identify key stressors and potential interventions. Methodology A cross-sectional study examined the psychological well-being, depression, anxiety, and stress of undergraduate (UG) and postgraduate (PG) dental students and faculty from the School of Dental Sciences. A questionnaire was distributed via email and WhatsApp to 350 participants. The questionnaire contained a unique set of items for each study group related to factors affecting psychological well-being among students, and a separate questionnaire was used to assess depression, anxiety, and stress (DASS-21) in the same population. Results A cross-sectional study of 350 dental students and educators found no significant changes in depression, anxiety, and stress (DASS) levels between age groups. Females, however, reported greater levels of these difficulties than men (D=71.5%, A=71.9%, S=76.7% for females vs. D=28.5%, A=28.1%, S=23.3% for men, with p-values for D=0.014, A=0.001, and S=0.031). Overall, 67.3% of UG students study away from home and live in hostels or flats, with academic and financial demands (30.6% and 33.5%, p-values: 0.014 and 0.098, respectively). Many people find their workload unpleasant (40.8%, p-value=0.143) and feel overwhelmed by academic obligations (47.9%, p-value=0.002), with 20%-25% worried about examinations, failure, and balancing well-being with academics (p-values: 0.001, 0.006, and 0.002, respectively). In total, 57.1% suffer severe social isolation (p-value=0.045), and more than 40% have mental health issues (p=0.003). While the mentor-mentee program is rated as helpful (p-value=0.68), 35% of students are ignorant of mental health options (p-value=0.006). Financial concerns are a big worry, with 38.7% seeking assistance, and second- and third-year students suffer more challenges than first-year students. Overall, 41.2% of instructors are perceived as extremely accessible, whereas 34.3% and 31.4% feel that scheduled breaks are required due to stress (38.2%, p=0.053). Most instructors (51.4%) encourage counseling and interact with students (76.5%), while 77.1% discuss mental health. Among the PGs, 74.2% of participants are content with the college's amenities, but 90.3% are stressed because of the PG seat departing bond, demonstrating widespread concern over this issue. To cope, 22.6% seek help from loved ones, while 19.4% pursue hobbies, emphasizing the value of personal support networks and leisure activities. Conclusion The study found that females perceive more stress than males. Most UG students live with supportive families and only experience academic helplessness on rare occasions. First-year students find academic effort more demanding than their peers at higher educational levels. Overall academic load gradually decreases from the first to the third year but rises significantly in the final year before declining during internships. As academic load increases, students tend to isolate themselves socially. Engaging in leisure activities can help mitigate the negative effects of stress on physical and psychological health. Faculty members recommend college counseling services to help students cope with stress.

A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain

BACKGROUND

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

METHODS

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

RESULTS

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

CONCLUSIONS

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

Infection Concerns and Economic Burden: Dentists' Cancellations During COVID-19

OBJECTIVES

During the COVID-19 pandemic, dental appointments were cancelled or postponed by both patients and dentists. This study investigated the associations between German dentists' concerns on cross infection and their emotional burden due to personal economic impact on dentist-initiated appointment cancellations.

METHODS

Data were collected using an anonymous cross-sectional online survey of outpatient physicians in Germany from March through April 2020. Dental treatments were divided into 3 treatment categories (plannable treatments, acute treatments without COVID-19-like symptoms, and acute treatments with COVID-19-like symptoms). Descriptive analyses and multivariate logistic regression models were performed.

RESULTS

A sample of 269 self-employed dentists was considered. Cancellations of prophylaxis appointments were reported by 82% of dentists, whilst 49% reported cancellations of appointments for acute complaints with simultaneous patient-side COVID-19-like symptoms. Further, 58% of respondents stated high or very high concerns about COVID-19 self-infection; 81% stated to be emotionally burdened by the personal economic impact. Dentists' concern of infecting themselves significantly decreased the likelihood of maintaining appointments, with odds ratios of 0.635 (95% confidence interval [CI], 0.426 to 0.932) for plannable treatments and 0.587 (95% CI, 0.367 to 0.916) for treatments of patients with acute complaints and simultaneous COVID-19-like symptoms. In addition, there was a significant negative association between dentists who reported emotional distress due to personal economic impact and the likelihood to maintain appointments, with odds ratios of 0.291 (95% CI, 0.123 to 0.695) for plannable treatments and 0.231 (95% CI, 0.053; 0.706) for treatments of patients without acute complaints and simultaneous COVID-19-like symptoms.

CONCLUSION

Dentists' fear of infecting themselves with COVID-19 played a role in terms of practice-related appointment cancellations. Dentists differentiated their appointment cancellations according to different treatment categories and patient needs. If dental care is to be maintained in pandemic times, physicians' personal factors such as concerns about infection and perceived pandemic-related personal economic impact need to be considered.

Mental health status and related factors influencing healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

The mental health of healthcare workers during the coronavirus-2019 pandemic was seriously affected, and the risk of mental health problems was high. The present study sought to systematically evaluate the mental health problems of healthcare workers worldwide during the pandemic and to determine the latest global frequency of COVID-19 associated mental health problems.

METHODS

Data in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Elsevier, MEDLINE, PubMed, PsycINFO and the Web of Science before November 11, 2022, were systematically searched. Cohort, case-control and cross-sectional studies were included. The meta-analysis used a random effects model to synthesize the comprehensive prevalence rate of mental health problems. Subgroup analyses were performed based on time of data collection; whether the country was or was not developed; continent; doctors and nurses; doctors/nurses vs. other healthcare workers; and psychological evaluation scale.

RESULTS

A total of 161 studies were included, including 341,014 healthcare workers worldwide, with women accounting for 82.8%. Occupationally, 16.2% of the healthcare workers were doctors, 63.6% were nurses and 13.3% were other medical staff. During the pandemic, 47% (95% confidence interval [CI], 35-60%) of healthcare workers reported job burnout, 38% (95% CI, 35-41%) experienced anxiety, 34% (95% CI 30-38%) reported depression, 30% (95% CI, 29-31%) had acute stress disorder, and 26% (95% CI, 21-31%) had post-traumatic stress disorder.

CONCLUSIONS

The study found that there were common mental health problems among health care workers during the COVID-19 pandemic. The most common was job burnout, followed by anxiety, depression, acute stress and post-traumatic stress disorder. Although the global pandemic has been brought under control, its long-term impact on the mental health of healthcare workers cannot be ignored. Additional research is required to develop measures to prevent, monitor and treat psychological disorders among healthcare workers.

A systematic review of dentists' psychological wellbeing during the COVID-19 pandemic

Background The COVID-19 pandemic presented significant challenges to healthcare workers worldwide, including the effect on the psychological wellbeing of dentists.Aims To evaluate the impact of the early phases of the pandemic on the psychological health, long-term wellbeing and clinical service provision of dentists, as well as the identification of the key risk and protective factors for adverse mental health outcomes (MHOs) in this group.Methods A systematic review of cross-sectional studies (n = 53) from public and private dentistry sectors was employed to delineate the risk and protective factors for adverse MHOs.Results Self-reports from these studies (1 December 2019 to 31 December 2021), involving 45,671 dentists worldwide were analysed. Study findings were classified according to their psychological impact (as risk or protective factors), categorised as 'operational' or 'organisational' and subdivided into 'psychosocial', 'occupational', 'sociodemographic' and 'environmental' elements. A GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) certainty of evidence score was calculated for all the identified factors.Conclusions This review confirmed the negative impact of the pandemic on the MHOs of dentists worldwide. Pivotal risk factors included fear of infection, transmission to families, lack of personal protective equipment and possible direct contact with infected patients. Enhanced infection control protocols, individual resilience and organisational support were identified as important protective factors.

Depression, Anxiety and Stress Associated With Fear of COVID-19 in Peruvian Dental Students: A Multivariate Analysis With 12 Sociodemographic Factors

Aims and Objectives

Excessive fear of coronavirus disease 2019 (COVID-19) in dental students could cause mood disorders, especially if there are factors in the environment that generate feelings of anxiety or uncertainty. The aim of this study was to evaluate the fear of COVID-19 and its association with depression, anxiety, and stress in Peruvian dental students according to their sociodemographic factors.

Materials and Methods

This analytical, observational, and cross-sectional study was conducted in 398 dental students of a public university in the Peruvian capital during April 2021 to July 2021. The Depression, Anxiety and Stress Scale-21 items was used to diagnose depression, anxiety, and stress. The Fear of COVID-19 Scale was used to detect fear of COVID-19. The Pearson's chi-square test was used for statistical analysis. In addition, a logit model using odds ratio (OR) was performed to evaluate depression, anxiety, and stress of students with the associated factors: fear of COVID-19 and 12 sociodemographic variables (gender, age group, marital status, year of study, origin, companion, living with vulnerable people, history of mental illness, history of COVID-19, loss of close relatives due to COVID-19, occupation, and area of residence). A significance level of P < .05 was considered. In addition, predictive models were developed for the variables depression, anxiety, and stress, considering all possible significant causes.

Results

The prevalence of fear of COVID-19, depression, anxiety, and stress was 19.6%, 36.2%, 40.7%, and 19.6%, respectively. According to the adjusted logit model, students who had fear of COVID-19 had OR = 2.74 (95% confidence interval [CI]: 1.62-4.64), OR = 5.59 (95% CI: 3.14-9.97), and OR = 3.31 (95% CI: 1.88-5.83) for developing depression, anxiety, and stress, respectively. In addition, those who reported history of mental illness were four times more likely to develop depression (OR = 4.02, 95% CI: 1.96-8.25) and anxiety (OR = 4.50, 95% CI: 2.06-9.82), whereas those living with people vulnerable to COVID-19 were twice as likely to develop stress (OR = 2.06, 95% CI: 1.16-3.66).

Conclusion

The highest prevalence of mood disorders among dental students was anxiety. In addition, those who were afraid of COVID-19 had three times the probability of developing depression and stress, and five times the probability of developing anxiety. On the other hand, the most influential factor in the development of depression and anxiety was history of mental illness, whereas the factor of living with vulnerable people was the most influential factor in the development of stress.

Psychological impact of COVID-19 Pandemic on dentists

BACKGROUND

The Covid-19 pandemic seems to have an incessant out-turn on the people in every field in some or the other way. It has been reported that maximum number of deaths in the countries during this pandemic are caused due to a term called death anxiety or phobia. There are certain parameters such as anxiety, apprehension, depression which if influence a person can alter one's well-being.

OBJECTIVE

The steadfast intent of this review article is to narrate the psychological impact of this pandemic on dentists. The eloquence and emergence of this topic will alarm all the medicos and paramedics to have a check on this scenario.

METHODS

The article consists of detailed study from several articles from PubMed publications. Articles written only in English language were referred. Various keywords such as "Covid-19 pandemic" or "Psychological Impact" were used.

RESULTS

The Covid-19 Pandemic has adversely affected all of us physically as well as psychologically. This article signifies the psychological impact of this pandemic on dentists.

CONCLUSION

The current studies that are carried out till date show an extensive impact on the psychology of the dental professionals. The following review article elaborates the importance of the same.

Dentists' lived experience of providing dental care during the COVID-19 pandemic: A qualitative study in Mashhad, Iran

Background

This study aimed to explore the lived experiences of dentists practicing in Mashhad, Iran, during the COVID-19 pandemic and identify possible influencing factors for providing dental health in this era.

Methods

Sixteen dentists took part in this qualitative phenomenological study. Semi-structured face-to-face interviews were performed and evaluated using a qualitative content analysis approach. The MAXQDA program (2020) was used to code and classify the data. Purposive sampling, audio recording, member checking, and peer review were employed to verify transferability, reliability, and validity. The interview transcripts were transcribed, and sentences and remarks relevant to the study's goal were retrieved and classified.

Results

Six hundred twenty-eight codes were extracted after several readings of the texts. Five core themes and fourteen sub-themes were determined after deleting repeated themes and axial coding. The main five themes included: "Coping with the COVID-19 pandemic", "Alternations in providing dental care," "Infection control," "COVID-19-related news and information sources", and "Positive and negative aspects of COVID-19 in dental care ".

Conclusions

During the COVID-19 pandemic, dentists noted various challenges in delivering routine dental treatment, including a lack of resources, reliable and straightforward guidelines for dentists, and governmental policies for dental facility restrictions. Dentists concluded that financial, educational, and financial support from the government would significantly enhance the delivery of community dental care services. With the right strategies and lessons learned, dentists may be better prepared for future challenges in global health care.

Psychological distress facing the COVID-19 pandemic in dental interns from the Peruvian capital: A cross-sectional study under a multivariable regression model

Aim

Psychological distress can be considered a maladaptive response to a stressful situation that occurs when external events or stressors impose demands that cannot be coped with. Therefore, the aim of the present study was to evaluate the sociodemographic factors associated with psychological distress in dental interns from the Peruvian capital facing the COVID-19 pandemic.

Materials and methods

This analytical, observational, cross-sectional study was conducted on 392 Stomatology interns from the Peruvian capital from June to July 2022. The validated COVID-19 Peritraumatic Distress Index (CPDI) scale to detect the levels of psychological distress consisted of four dimensions: negative mood, changes in behavior and cognitive skills, fatigue and hyperreactivity, and somatization. Pearson's chi-square and Fisher's exact test were used for bivariable analysis. In addition, a logit model was used to assess the influence of variables: sex (X1), age group (X2), marital status (X3), monthly economic income (X4), working area in the capital city (X5), and living with people vulnerable to COVID-19 (X6), with the psychological distress levels, considering a significance p < 0.05.

Results

The prevalence of psychological distress in dental interns was severe in 6.4% [95% confidence interval (CI): 3.9-8.8%] and mild in 37.8% (95% CI: 33.0-42.6%). According to bivariable analysis, the levels of psychological distress by COVID-19 were not significantly associated with sex (p = 0.190), age group (p = 0.418), marital status (p = 0.554), monthly economic income (p = 0.327), working area in the capital city (p = 0.993), and living with people vulnerable to COVID-19 (p = 0.134). In addition, according to the logistic regression analysis, none of the variables studied was considered an influential factor (p > 0.05) in psychological distress presented by dental interns.

Conclusion

The 44.2% of dental interns from the Peruvian capital presented psychological distress facing the COVID-19 pandemic, without any of the possible associated variables of this study significantly affecting this behavioral disorder.

Psychological Impact of COVID-19 in the Setting of Dentistry: A Review Article

The worldwide pandemic has exposed healthcare professionals to a high risk of infection, exacerbating the situation of uncertainty caused by COVID-19. The objective of this review was to evaluate the psychological impact of the COVID-19 pandemic on dental professionals and their patients. A literature review was conducted using Medline-Pubmed, Web of Science, and Scopus databases, excluding systematic reviews, narratives, meta-analyses, case reports, book chapters, short communications, and congress papers. A modified version of the Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the selected studies. The search retrieved 3879 articles, and 123 of these were selected for the review (7 longitudinal and 116 cross-sectional studies). Elevated anxiety levels were observed in dental professionals, especially in younger and female professionals. Except for orthodontic treatments, patients reported a high level of fear that reduced their demand for dentist treatment to emergency cases alone. The results suggest that the COVID-19 pandemic has had psychological and emotional consequences for dental professionals and their patients. Further research is necessary to evaluate the persistence of this problem over time.

Psychological Impact of the COVID-19 Pandemic on Dentists in Latin America's Epicenter: São Paulo, Brazil

The present study aimed to assess the prevalence and associated factors of stress and anxiety symptoms among dentists during the COVID-19 pandemic in the state of São Paulo, Brazil. A structured questionnaire was sent electronically to 93,280 dentists with active registration in the Dental Council of São Paulo, Brazil, enquiring about information regarding the first-wave peak period in Brazil. Descriptive analyses of background characteristics, perceptions of preparedness, and psychological impact were calculated. Multiple logistic regression analysis was performed, and independent variables that showed p < 0.20 were used in the adjusted logistic regression model to compare the psychological impact on dental professionals. Among the 2113 respondents, female participants had 63% lower chance of reporting anxiety than males. Older dentists had a lower likelihood of reporting anxiety compared to 21-30-year-old dentists (p ≤ 0.05). Dentists working in the public health service were 1.78 times more likely to report anxiety than those who worked in private practice. Finally, dentists in the COVID-19 high-risk group and those with a family or team member with a positive COVID-19 diagnosis were more likely to have anxiety. This study can help dental and other healthcare professionals to better understand the consequences of COVID-19 in terms of mental health.

COVID-19 incidence, severity, medication use, and vaccination among dentists: survey during the second wave in Brazil

Objective

This cross-sectional study with dentists in Brazil assessed the COVID-19 incidence and severity, its vaccination status, and the level of confidence in vaccines in May 2021 (COVID-19 second wave). The medications used to prevent or treat COVID-19, including controversial substances (vitamin D, ivermectin, zinc, and chloroquine), were analyzed.

Methodology

Dentists were recruited by email and responded to a pretested questionnaire until May 31, 2021. Bivariate and multivariate regression analyses were performed (α=0.05). Prevalence ratios were calculated for the association between professional characteristics and two outcomes: SARS-CoV-2 infection and use of controversial substances.

Results

In total, 1,907 responses were received (return rate of 21.2%). One third of dentists reported intermediate levels of confidence in the safety and efficacy of COVID-19 vaccines, but 96% had received at least one vaccine dose, mainly CoronaVac. The effect of the pandemic on dental practice was classified as lower/much lower, in comparison with the first wave, by 46% of participants. Moreover, 27% of dentists had already tested positive for SARS-CoV-2 and about 50% had relatives or friends who had been hospitalized or died from COVID-19. At least one medication was used by 59% of participants and 43% used two or more substances. Vitamin D (41%), ivermectin (35%), and zinc (29%) were the most frequent substances. More experienced dentists (≥21 years of professional experience) were 42% more likely to use controversial substances than less experienced dentists. The prevalence of use of controversial substances was 30% higher among dentists with residency or advanced training, such as postgraduate degrees, in comparison with participants holding MSc or PhD degrees. Participants with low confidence in vaccines were 2.1 times more likely to use controversial substances than participants with a very high confidence.

Conclusion

The results of this study show the high severity of the COVID-19 pandemic in Brazil and raised questions about the use of scientific evidence by dentists in their decision to use controversial substances.

Quality of Life and Satisfaction from Career and Work-Life Integration of Greek Dentists before and during the COVID-19 Pandemic

Quality of life (QoL) of dental professionals is a basic parameter of the quality of dental services (QS), a fact well-documented before and during the COVID-19 pandemic in different countries. This study is a comprehensive, cross-sectional survey aimed to explore possible differences in satisfaction from career and work-life integration, as well as QoL in a sample of Greek dentists during the second lockdown in March 2021. Methods: 804 dentists from the vast metropolitan area of Athens and Piraeus selectively responded by completing a self-reported questionnaire based on: the Copenhagen Questionnaire (CQ) for assessing work stress; the Maslach Burnout Inventory-Human Service Survey (MBI-HSS) for evaluating personal accomplishment; and the Quality-of-Life work scale (ProQOL-CSF). Data were analyzed using the independent t-test, ANOVA, Pearson's correlation, and multiple linear regression. Results: QoL and career satisfaction were significantly diminished during the pandemic. Career satisfaction despite the pandemic was overall influenced in tandem by age (b = 0.427, p = 0.001), marital status (b = 0.276, p = 0.021), and inversely by years of practice (b = -0.330, p = 0.007) and income (b = -0.221, p = 0.015). Satisfaction from the work-life integration was influenced before the pandemic by marital status (b = 0.255 p = 0.013), years of practice (b = -0.371, p = 0.0001), while gender, years of practice, age, higher education, and income played a significant role during the pandemic. QoL was impacted before pandemic by age (b = -1.007, p = 0.001), number of children (b = -1.704, p = 0.018), and higher degree (b = -1.143, p = 0.001), while during the pandemic by gender (b = -0.582, p = 0.002), number of children (b = 0.469, p = 0.037), higher degree (b = 0.279, p = 0.009), and years of practice (b = -0.523, p = 0.0001). Males were more prone to low QoL, and dissatisfaction with career and work-life integration, during the pandemic. Income is a predictor of career satisfaction despite the pandemic. Personal resources through deep human relationships, higher education, beliefs, and values can offer a resilience shield against professional difficulties in periods of unexpected stressful events.

US dental health care workers' mental health during the COVID-19 pandemic

BACKGROUND

This study was designed to assess the prevalence of anxiety and depression symptoms and understand factors influencing mental health among dental health care workers (DHCWs) during the COVID-19 pandemic.

METHODS

Beginning in June 2020, 8,902 DHCWs participated monthly in an anonymous longitudinal, web-based survey (response rate, 6.7%). The Patient Health Questionnaire-4 was used to estimate rates of anxiety and depression symptoms. Changes in mental health over time and differences by demographic and practice characteristics, COVID-19 community transmission level, and COVID-19 vaccination status were tested using χ² tests and multilevel multivariable logistic regression.

RESULTS

Anxiety symptom rates peaked in November 2020 (28% of dental hygienists, 17% of dentists) and declined to 12% for both professions in May 2021. Depression symptom rates were highest in December 2020 (17% of dental hygienists, 10% of dentists) and declined to 8% in May 2021. Controlling for gender, age, race or ethnicity, and COVID-19 community transmission level, the authors found that dentists had significantly lower odds of anxiety symptoms (adjusted odds ratio [aOR], 0.82; 95% CI, 0.70 to 0.95) and depression symptoms (aOR, 0.79; 95% CI, 0.67 to 0.93) than dental hygienists. Compared with vaccinated respondents, those who were unvaccinated but planning on getting vaccinated had significantly higher rates of anxiety (aOR, 1.71; 95% CI, 1.20 to 2.44) and depression (aOR, 1.57; 95% CI, 1.07 to 2.29) symptoms.

CONCLUSIONS

DHCWs' mental health fluctuated during the pandemic. Anxiety and depression in DHCWs were associated with demographic and professional characteristics as well as perceived risk of COVID-19.

PRACTICAL IMPLICATIONS

Mental health support should be made available for DHCWs. This clinical trial was registered at ClinicalTrials.gov. The registration numbers are NCT04423770 and NCT04542915.

Dental Care and Education Facing Highly Transmissible SARS-CoV-2 Variants: Prospective Biosafety Setting: Prospective, Single-Arm, Single-Center Study

With the arrival of the highly transmissible Omicron variants (BA.4 and BA.5), dentistry faces another seasonal challenge to preserve the biosafety of dental care and education. With the aim of protecting patients, students, teachers and healthcare professionals, this paper introduces a prospective sustainable biosafety setting for everyday dental care and education. The setting developed by dental clinicians, epidemiologists, and teachers of dentistry consists of a combination of modern technologies focused on the air-borne part of the viral pathway. The introduced biosafety setting has been clinically evaluated after 18 months of application in the real clinical environment. The protocol has three fundamental pillars: (1) UVC air disinfection; (2) air saturation with certified virucidal essences with nebulizing diffusers; (3) complementary solutions including telehealth and 3D printing. A pseudonymous online smart form was used as the evaluation method. The protocol operates on the premise that everybody is a hypothetical asymptomatic carrier. The results of a clinical evaluation of 115 patient feedbacks imply that no virus transmission from patient to patient or from doctor to nurse was observed or reported using this protocol, and vice versa, although nine patients retrospectively admitted that the clinic visit is likely to be infectious. Despite these promising results, a larger clinical sample and exposition to the current mutated strains are needed for reliable conclusions about protocol virucidal efficiency in current dental environments.

Probable Bruxism and Psychological Issues among Dental Students in Serbia during the COVID-19 Pandemic

The COVID-19 pandemic has drastically changed the routine way of life, having consequences in many segments of life, including dental practice and education. The aim of this study was to evaluate the frequency of probable bruxism in a sample of dental students in Serbia and to estimate the potential association between psychological factors related to the COVID-19 pandemic and the presence of bruxism. A cross-sectional study included 178 dental students in Serbia, who were interviewed using a specially-designed self-administered online questionnaire, which consisted of three sections, and after that, a clinical examination for the presence of bruxism symptoms in the oral cavity. Psychological status was evaluated using the Depression, Anxiety and Stress Scale-21 (DASS-21) and the Fear of COVID-19 Scale (FCV-19S). Saliva samples were taken to analyze salivary cortisol levels. The prevalence of probable bruxism was 34.8%. Respondents with probable bruxism had significantly higher DASS-21 and FCV-19S scores and mean values of salivary cortisol compared to non-bruxers. A history of COVID-19 infection, high stress, and fear of COVID-19 scores were associated with the presence of probable bruxism. The findings suggest that the COVID-19 pandemic has had a great psychological impact and impact on the presence and worsening of bruxism symptoms in a sample of dental students in Serbia.

Estimation of Factors Affecting Burnout in Greek Dentists before and during the COVID-19 Pandemic

This study is a comprehensive, cross-sectional survey in occupational burnout, career satisfaction, and quality of life conducted in March 2021 among dentists in the vast area of metropolitan Athens, Greece. Data were collected using a self-reported questionnaire based on the Copenhagen Questionnaire (CQ) for assessing work stress and the Maslach Burnout Inventory-Human Service Survey (MBI-HSS) for evaluating occupational burnout. Using the independent t-test, ANOVA, Pearson's correlation, and multiple linear regression, 804 valid questionnaires were analyzed. During the pandemic, personal exhaustion was affected by gender (b = 1.862, p = 0.0001), age (b = -0.598, p = 0.0001), number of children (b = -0.886, p = 0.020) and higher degree (b = -0.450, p = 0.012). Exhaustion due to working with patients was affected by gender (b = 0.662 p = 0.0001), age (b = -0.513, p = 0.0001), number of children (b = -0.701, p = 0.0001), higher degree (b = -0.207, p = 0.028) and years in practice (b = 0.408 p = 0.0001). Males were more prone to unhappiness, dissatisfaction, and professional physical and emotional exhaustion, but personal resources through higher education, beliefs, values, and hobbies can offer a preventive shield to all dental professionals. Economic management issues can also enhance dentists' satisfaction and feeling of safety in a rapidly changing environment.

Psychological impact of the COVID-19 epidemic among healthcare workers in paediatric intensive care units in China

To perform a mental health evaluation and an early psychological intervention for healthcare workers (HCWs) during the coronavirus disease 2019 (COVID-19) epidemic, an online survey was conducted among 3055 HCWs in the paediatric intensive care units (PICUs) of 62 hospitals in China on March 26, 2020, by the Neurology and Sedation Professional Group, Emergency Department, Paediatrics Branch, Chinese Medical Association. The questionnaire was divided into three parts, including general information, the Impact of Event Scale-Revised (IES-R), and the Depression Anxiety Stress Scale-21 (DASS-21). The results show that a total of 970 HCWs (45.99%) were considered to meet the clinical cut-off scores for posttraumatic stress (PTS), and the proportions of participants with mild to extremely severe symptoms of depression, anxiety and stress were 39.69%, 36.46% and 17.12%, respectively. There was no significant difference in the psychological impact among HCWs of different genders. Married HCWs were 1.48 times more likely to have PTS than unmarried HCWs (95% Cl: 1.20-1.82, p <0.001). Compared with junior professional title participants, the PTS-positive rate of HCWs with intermediate professional titles was 1.91 times higher (90% Cl: 1.35-2.70, p<0.01). Those who had been in contact with confirmed COVID-19 cases were 1.40 times (95% Cl: 1.02-1.92, p <0.05) more likely to have PTS than those who did not have contact with COVID-19 cases or did not know the relevant conditions. For depression, the proportion of HCWs with intermediate professional titles was significantly higher, at 1.65 times (90% Cl: 1.17-2.33, p <0.01) that of those with junior professional titles. The depression of HCWs at work during the epidemic was 1.56 times that of HCWs on vacation (95% Cl: 1.03-2.37, p <0.05), and their anxiety was 1.70 times greater (95% Cl: 1.10-2.63, p <0.05). Participants who had been in contact with confirmed COVID-19 cases had more pronounced anxiety, 1.40 times that of those who did not have contact with COVID-19 cases or did not know the relevant conditions (95% Cl: 1.02-1.92, p <0.05). There was no significant correlation between the variables and the positive results of stress symptoms. In total, 45.99%, 39.69%, 36.46% and 17.12% of PICU HCWs were affected by PTS, depression, anxiety and stress, respectively, to varying degree. Married status, intermediate professional titles and exposure history were independent risk factors for PTS. Intermediate professional titles and going to work during the epidemic were independent risk factors for depression, and going to work and exposure history during the epidemic were independent risk factors for anxiety. In the face of public health emergencies, HCWs not only specialize in paediatric intensive care but also, as a high-risk group, must actively take preventive measures and use mitigation strategies.

General Labor Well-Being in Latin American Dentists during the COVID-19 Pandemic

This study aimed to determine the general labor well-being of Latin American dentists according to sociodemographic characteristics during the COVID-19 pandemic. A cross-sectional study was conducted in a final sample of 2214 participants from 11 countries. A validated online questionnaire on general work well-being was used (data collection period from 1 June to 10 July 2021), containing two dimensions: psychosocial well-being and collateral effects. The sociodemographic characteristics of the dentists and their perception of the economic impact of the pandemic were also recorded. A multivariate linear regression analysis was performed (hierarchical regression model) to evaluate the joint effect of the explanatory variables on labor well-being and the changes in the variance between each model. A score of psychosocial well-being of 233.6 + 40.2 and collateral effects of 45 + 20.1 was found. Psychosocial well-being was associated with sex, country of origin, academic training achieved, type of dental activity, and perceived impact during the pandemic (p < 0.05). Somatization was frequently manifested through back pain (88.2%) and muscular tensions (87.2%). Women, those who worked 41 or more hours and had between 1 to 15 years of professional experience presented a greater collateral effect (p < 0.001). The impact of the COVID-19 pandemic a year and a half after it began on the labor well-being of Latin American dentists was evidenced with important interactions with social characteristics.

Effect of dental trauma management resources on dental practitioners' confidence and knowledge: A pilot cross-sectional study

BACKGROUND/AIM

The knowledge of standardized care guidelines is critical to the confidence of practitioners in managing dental trauma. Therefore, the aim of this study was to assess the awareness, use and impact of the International Association of Dental Traumatology guidelines, and the online Dental Trauma Guide on general dental practitioners' self-reported confidence and knowledge in managing traumatic dental injuries in the primary and permanent dentitions.

MATERIALS AND METHODS

A cross-sectional, pre-piloted, 27-item self-administered questionnaire survey was distributed electronically to general dental practitioners' working within five member states of the Gulf Cooperation Council countries (Kingdom of Bahrain, Kingdom of Saudi Arabia, Kuwait, Oman, and Qatar) between September and December 2020. Data were collected and analysed using descriptive statistics and Wilcoxon Signed Rank test analysis for relevant comparisons.

RESULTS

A total of 294 respondents completed the survey, with the majority being from the Kingdom of Saudi Arabia (47.4%) and Qatar (27.3%). A lack of evidence-based knowledge in managing traumatic dental injuries was evident among more than half of the respondents. Respondents who were cognizant of the recent International Association of Dental Traumatology guidelines (2020) and those who use the Dental Trauma Guide routinely demonstrated a higher self-reported confidence level in managing both simple and complex primary dentition trauma, as well as simple traumatic dental injuries in the permanent dentition (p < .05).

CONCLUSION

This survey highlights critical deficiencies in the knowledge of a large number of the respondents in the management of dental trauma which is likely to cause irreversible long-term patient effects.

COVID-19 Pandemic Impact on Dental Practice

Introduction: The COVID-19 pandemic has had a huge impact on the dentistry industry from the initial lockdown in March 2020 to the present day, nearly one year later with dentists unable to practice during the initial lockdown, that is when revenue took the biggest hit. The study aims to examine the impact of COVID-19 on dental practices during the pandemic in Bulgaria. Material and methods: A specially developed questionnaire was distributed electronically among 138 dentists from all regions of Bulgaria. The collected primary statistical information was entered and processed with the statistical package SPSS Statistics 19.0 Results: Statistical analyzes of the questionnaire show that (62,32%±4,12) of dentists say COVID-19 made no impact on their decision to retire or continue practicing; 43% of respondents predict revenue or costs will be the biggest challenge facing their practice in 2021. Part of dentists (34.78 % ± 4,05) believe that COVID-19 allowed them to learn more about infection control. Most of the respondents (87.68% ± 2.79) agree their income was lower in April to September of 2020 compared to 2019. More than half of dentists (61.59 % ± 4.14) believe Covid 19 has not impacted the products or services they offer. The majority of the participants (84.78 % ± 3.05) did not perform non-emergency procedures during the pandemic. Conclusion: Despite the numerous disadvantages caused by the COVID-19 pandemic, our survey shows dentists have found ways to adapt and succeed. Introduction: The COVID-19 pandemic has had a huge impact on the dentistry industry from the initial lockdown in March 2020 to the present day, nearly one year later with dentists unable to practice during the initial lockdown, that is when revenue took the biggest hit. The study aims to examine the impact of COVID-19 on dental practices during the pandemic in Bulgaria. Material and methods: A specially developed questionnaire was distributed electronically among 138 dentists from all regions of Bulgaria. The collected primary statistical information was entered and processed with the statistical package SPSS Statistics 19.0 Results: Statistical analyzes of the questionnaire show that (62,32%±4,12) of dentists say COVID-19 made no impact on their decision to retire or continue practicing; 43% of respondents predict revenue or costs will be the biggest challenge facing their practice in 2021. Part of dentists (34.78 % ± 4,05) believe that COVID-19 allowed them to learn more about infection control. Most of the respondents (87.68% ± 2.79) agree their income was lower in April to September of 2020 compared to 2019. More than half of dentists (61.59 % ± 4.14) believe Covid 19 has not impacted the products or services they offer. The majority of the participants (84.78 % ± 3.05) did not perform non-emergency procedures during the pandemic. Conclusion: Despite the numerous disadvantages caused by the COVID-19 pandemic, our survey shows dentists have found ways to adapt and succeed.

Oral Habits during the Lockdown from the SARS-CoV-2 Pandemic in the Romanian Population

Background and Objectives: The SARS-CoV-2 pandemic led to changes in population daily patterns. In order to adapt oral health promotion measures for future similar conditions, the main objective of the study was to assess changes in dental hygiene and eating and smoking habits during the government lockdown in Romania. Materials and Methods: The cross-sectional study was conducted immediately after the end of the lockdown and consisted of 800 adult subjects. Data collection was done via an online survey. Participants were divided into two groups: non-medical/dental practitioners (N-M/D group) and medical/dental practitioners (M/D group). Results: An increased use of dental floss from 27% (pre-lockdown) to 30.5% (during lockdown) was identified in the M/D group, while the manual toothbrush usage increased to 64.8% (during lockdown) from 61.7% (pre-lockdown) in the N-MD/group. No significant differences regarding toothbrushing frequency were observed in either group. A change in the number of daily snacks was identified in both groups (3–4 snacks per day: from 11% to 20.2% in the N-M/D group, from 13.1% to 22.2% in the M/D group). The consumption of sweets as a preferred snack was also noticed. A decrease of tobacco consumers was assessed in the lockdown period (from 66.6% to 60.4% in the M/D group, from 68.5% to 61.9% in the N-/M/D group). Conclusions: Oral habits were changed during the pandemic lockdown through the increase in the frequency of the consumption of snacks and sweets and the decrease in frequency of smokers. Only minor changes were observed in oral hygiene.

Australian dentists' knowledge, preparedness, and experiences during the COVID-19 pandemic

BACKGROUND

COVID-19 is a global health crisis. Close contact with the mucous membranes and respiratory secretions of patients and aerosol-generating procedures renders dentists and other oral health professionals at high risk of exposure to SARS-CoV-2. We examined dentists' knowledge, preparedness, and experiences of managing COVID-19 in Australia.

METHODS

A cross-sectional online survey of dentists with a current membership with The Australian Dental Association (ADA) was conducted between March and April 2021.

RESULTS

Of the 368 survey responses, most dentists (72.3%) reported having a good level of knowledge about COVID-19, with most visiting the ADA Federal COVID-19 (74.7%) and state/territory department of health websites (62.8%), respectively to source up-to-date information. Most dentists (87.6%) felt prepared to manage COVID-19 into the future, although 66% reported not receiving training or certification in the use of PPE. Over half (58.7%) reported not being concerned about contracting SARS-CoV-2 at work, with some (28.9%, n = 98/339) feeling more stressed than usual and having heavier workloads.

CONCLUSION

COVID-19 had significant impact in oral healthcare in Australia. Dentistry has adapted to the varied challenges raised by the pandemic. Comprehensive training and detailed guidelines were fundamental for successful patient management during the COVID-19 outbreak.

The impact of the COVID-19 pandemic on the mental health of dentists in Wales

Introduction The COVID-19 pandemic has had a large impact on dentistry across Wales. Dentists were facing significant levels of psychological distress prior to the pandemic, so it was important to monitor dentists' mental health during this unprecedented challenge.

Aims To gain both an understanding of the impact that the COVID-19 pandemic has been having on the mental health of dentists working in Wales, as well as understanding the levels of stress the pandemic has caused. We also aimed to understand the specific causes of stress.

Results High levels of stress were found, with 82% of respondents saying stress levels in the dental team have increased noticeably. Three-quarters of respondents have gone to work despite not feeling mentally well enough. Working conditions and financial pressures caused by the pandemic have directly impacted the mental health of many dentists. As a result, they have been using both adaptive and maladaptive coping methods to cope with the stress of the pandemic, with over one-third of respondents drinking alcohol more frequently than before the pandemic.

Conclusions The pandemic has had a profound impact on the professional lives of dentists working in Wales. Their interactions with patients and colleagues have been greatly affected, as well as their work and working conditions. These have all substantially contributed to increased stress levels. Without significant improvements to the working conditions of dentists, as well as continued psychological support, large-scale burnout in the future is not only possible, but likely.

Provides detailed information of the stressors dentists dealt with during the pandemic and looks at how many dentists cannot cope with the stress of their job during the pandemic.

Looks at the maladaptive coping methods dentists have used over the course of the pandemic, such as alcohol and nicotine products, as well as the adaptive coping methods dentists have used, such as walks and mindfulness.

Discusses how many dentists went to work despite not feeling mentally well enough to do so, plus looks at the impact the pandemic has had on dentists' sleep.

Looks at the working conditions dentists in Wales are facing due to the pandemic and the way different aspects of dentistry have been affected.

"We will have to learn to live with it": Australian dentists' experiences during the COVID-19 pandemic

BACKGROUND

Australian dentists are among the frontline healthcare workers providing dental and oral health care during the COVID-19 pandemic, and therefore have been affected in multiple ways. In this study, we explore their experiences of practising and living in this pandemic.

METHODS

A qualitative study analysed responses of 333 Australian dentists' who participated in a survey with open-ended questions about the challenges and positive outcomes of practising during the COVID-19 pandemic. The questions were embedded in a national online survey of Australian dentists' knowledge, preparedness and experiences conducted between March and April 2021. Data were analysed using content analysis.

RESULTS

Australian dentists reported their challenging experiences to be four-fold, including 'public health orders and restrictions', 'Infection prevention and control measures (IPC), 'Personal concerns about COVID-19' and 'Detracting opinions about COVID-19'. Conversely, they reported positive outcomes in relation to their practice during COVID-19, including 'Awareness of and adherence to IPC practices', 'Teamwork and interpersonal dynamics', 'Decompressed workload', 'Perceived support' and 'unintended positive outcomes'.

CONCLUSION

The COVID-19 pandemic generated several challenges for Australian dentists, but it also engendered some positive outcomes. Understanding of these can help tailor the professional support plans to address the needs and priorities of Australian dentists during the current and future pandemics.

Knowledge and Attitude of Polish Dental Healthcare Professionals during the COVID-19 Pandemic

Objectives: This study analyzed Polish dentists’ knowledge of the SARS-CoV-2 virus and the main problems in their work during the early phase of the pandemic. Methods: Dentists responded to an online anonymous survey consisting of 57 questions relating to socio-demographics, knowledge about COVID-19, and office procedures. The obtained data were analyzed using basic descriptive statistics, significance of dependencies and Chi square and Mann–Whitney tests; p < 0.05. Results: Ultimately, responses from 730 dentists were included. The mean age was 43.62 ± 11.57. Almost 3/4 of the respondents followed the information on COVID-19. A total of 95.5% had knowledge about COVID-19. Genetic testing was the basic test according to 69.2%. Further, 56.0% were concerned about the pandemic, and 23.6% were significantly anxious. In addition, 42.1% considered a risk of infection with the SARS-CoV-2 in the workplace as very high. A total of 84.0% admitted patients performing a triage and using personal protective equipment (PPE). Further, 44.5% planned to become vaccinated. Continuing the work during the pandemic was strongly correlated with age, sector, and location and duration of work. Conclusions: Most Polish dentists follow the information on the COVID-19 protocol and have sufficient knowledge about COVID-19. Dentists are concerned and anxious about the situation. The vast majority admitted patients during the pandemic and use PPE. Only almost half plan to be vaccinated.

Risk of PTSD Due to the COVID-19 Pandemic Among Patients in Opioid Substitution Treatment

Background: The impact of the COVID-19 pandemic on the mental health of patients suffering from addictive disorders is of major concern. This study aimed to explore the presence and potential increase in post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety since the beginning of the pandemic for patients in opioid substitution therapy (OST). Methods: This cross-sectional survey study evaluated a clinical sample of patients in OST (N = 123). Symptoms of post-traumatic stress disorder (PTSD) due to the COVID-19 pandemic were assessed by an adapted version of the impact of event scale (IES-R), resulting in two subgroups of low and high risk for PTSD. The depression, anxiety, and stress scale (DASS-21) was applied to collect data on the respective symptoms, and changes since the onset of the pandemic were reported on separate scales. Sociodemographic and COVID-19 related factors, as well as data on craving, consumption patterns, concomitant use, and the drug market were further assessed. Results: A binary logistic regression analysis confirmed the impact of self-perceived higher burden by psychological and economic factors on the elevated risk for PTSD due to the pandemic. The high-risk PTSD group also showed higher levels of depression, anxiety and stress, as well as a more pronounced deterioration in these symptoms since the pandemic. While reported levels of craving did not differ between the two groups, the high-risk PTSD group indicated a significantly higher increase in craving since the crisis, when compared to the low-risk group. Discussion: Our findings demonstrate elevated levels of clinical symptoms among patients in OST, with more than a quarter of patients found at risk for PTSD due to the COVID-19 pandemic. Furthermore, about 30-50% of our patients reported concerning levels of depression, anxiety, or stress. Special attention should be drawn to these findings, and potential deterioration of the situation should be addressed by health care facilities. Particularly, psychological, and financial burden due to the crisis were identified as factors increasing the risk for PTSD. These factors can easily be evaluated during routine anamneses, and might be a valuable source of information, when special attention is needed.

Dental Nurses' Mental Health in Germany: A Nationwide Survey during the COVID-19 Pandemic

Several studies have found a rise in the rate of psychological discomfort among healthcare personnel since the COVID-19 pandemic outbreak. In this study, we analyzed the relationship between psychological variables of anxiety, depression, stress, avoidance, intrusion and hyperarousal and several factors among German dental nurses. For this poll, dental nurses were asked nationwide to take part via an online-based survey from July 2020 to January 2021. This survey gathered data on demographics, as well as psychological assessments through the Impact of Events Scale-Revised (IES-R) instrument, and the Depression Anxiety Stress Scales (DASS-21). The correlations between DASS-21/IES-R ratings and sociodemographic data were investigated using univariate analyses (Kruskal-Wallis and Mann-Whitney U tests). Single comparisons were performed using the Dunn-Bonferroni post hoc test if a relevant test result was significant followed by multiple linear regressions. Furthermore, 252 dental nurses took part in the study and showed overall normal or mild results of all psychological variables. Having immune-deficiency or chronic diseases, employment at a dental practice, being married, having no children and seeing the pandemic as a financial threat were presented as significant risk factors (p ≤ 0.05) with higher DASS-21 and IES-R scores. These results emphasize the aspects that must be considered to safeguard German dental nurses' mental wellbeing during the crisis.

Dental Students in Germany throughout the COVID-19 Pandemic: A Psychological Assessment and Cross-Sectional Survey

Multiple investigations have reported high psychological distress among students since the coronavirus (COVID-19) outbreak started. This survey examined the associations between psychological features, and several demographic and social factors among dental students in German universities. Dental students registered in German universities nationwide were asked to join this survey via a self-directed online questionnaire, from July 2020 to January 2021. This study assembled data on demographic statistics, the depression anxiety stress scales (DASS-21), and the impact of events scale-revised (IES-R) instrument. The relationships between demographic-related variables and mental consequences of depression, anxiety, stress, intrusion, avoidance, and hyperarousal were inspected. Two hundred and eleven students contributed to the questionnaire and conveyed overall normal or mild outcomes of depression, anxiety, stress, intrusion, avoidance, and hyperarousal. In addition, female gender, cardiovascular diseases, smoking habits, and seeing the COVID-19 outbreak as a financial risk were stated as significant related factors (p < 0.05), with increased IES-R and DASS-21 scores. These results highlight the features that should be considered to better protect dental students' mental health in German universities during the crisis.

Safety of ChAdOx1 nCoV-19 Vaccine: Independent Evidence from Two EU States

Recent reports of thrombosis following AstraZeneca COVID-19 vaccine in young females (<55 years-old) led to temporary suspension and urgent investigation by the European Medicines Agency (EMA) that concluded that vaccine benefits still outweigh its side effects (SEs). Therefore, this study aims to provide early independent evidence on the vaccine SEs’ prevalence and their potential risk factors; a cross-sectional survey-based study was carried out between February and March 2021 in Germany and Czech Republic among healthcare workers who recently received the AstraZeneca COVID-19 vaccine. The study used a validated self-administered questionnaire composed of twenty-eight multiple-choice items covering demographic variables, medical anamneses, and local, systemic, oral, and skin related SEs of the vaccine. Out of the ninety-two included participants, 77.2% were females and 79.3% were from Germany. Their mean age was 35.37 ± 12.62 (19–64) years-old, 15.2% had chronic illnesses and 22.8% were receiving medical treatments. Overall, 94.6% of the participants reported at least one SE. The most common local SE was injection site pain (72.8%), and the most common systemic SEs were fatigue (73.9%), muscle pain (55.4%), chills (48.9%), feeling unwell (46.7%), nausea (45.7%), and headache (29.3%). The vast majority (91.9%) resolved within 1–3 days, and the below 35 years-old group was the least affected age group. The SEs’ frequency was insignificantly higher in females and previously infected participants; the vaccine safety for the elderly was supported by the early findings of this study. Chronic illnesses and medical treatments were not associated with an increased risk of SE incidence and frequency. No blood disorder SEs were reported in our sample. Further independent studies are highly required to evaluate the safety of the AstraZeneca vaccine and to explore whether gender or previous infection could be associated with the vaccine SEs.

Perceived Stress in Dentists and Dental Students of Latin America and the Caribbean during the Mandatory Social Isolation Measures for the COVID-19 Pandemic: A Cross-Sectional Study

This study aims to determine the impact of the COVID-19 pandemic, specifically considering the mandatory social isolation measures implemented, on the perceived stress of a sample of dentists and dental students from Latin America and the Caribbean, as well as the associated sociodemographic and pandemic-related variables. A cross-sectional survey was conducted with a sample of 2036 dentists and dental students (1433 women). For the main outcome, the 14-item Perceived Stress Scale (PSS-14) was used. The survey also questioned sociodemographic aspects, questions on the COVID-19 pandemic, health variables, and habits. Descriptive, bivariate, and multivariate analyses (linear regression) were applied to observe the factors associated with perceived stress. The PSS-14 mean score was 24.76 (±11.76). Hierarchical regression models showed significant variables associated with the PSS-14 scores: income level during mandatory social isolation, having older adults under care during mandatory social isolation, self-perceived level of concern regarding COVID-19, self-perceived health, Coffee consumption during mandatory social isolation. In general terms, the pandemic has influenced the personal, social, labor, and everyday life of dental staff and affected the mental health of this population specifically when perceived stress is considered. Public policies, strategies, and mental health surveillance systems are required for this population.

Evaluating the Practice of Preventive Behaviors and the Fear of COVID-19 among Dentists in Oradea Metropolitan Area after the First Wave of Pandemic; a Cross-Sectional Study

Dental clinics were suspected to be a hotspot for nosocomial transmission of COVID-19 due to the easy spread of the virus. The study investigated the preventive behaviors applied in dentistry settings and the level of fear of COVID-19 infection among dentists. A total of 83 respondents (34.94% male and 63.86% female) were included in the research. Sociodemographic data were collected, together with new institutional and personal rules regarding preventive behaviors. Fear of COVID-19 Scale was used to measure the fear of infection. Data was analyzed using SPSS (v.25, SPSS Inc., Chicago, IL, USA). During the first seven months of confinement, 3.9% of dentists were confirmed with COVID-19 and one fourth treated confirmed positive patients. A quarter of the doctors declared that they had periods when they lived away from home being afraid of transmitting the disease to their family members, and significant data were found in doctors being parents. The closure of dental offices had a negative impact on the financial situation of dentists, especially on those working in rural area offices. Many doctors encountered difficulties in purchasing protective suits and medical supplies, and more than half of the respondents (65.1%, N = 54) focused on the quality of protective suits when purchasing them. More than half of the dentists were trained how to use them. The score for fear of COVID 19 was similar to dentists from other countries. Respondents with chronic diseases were more prone to show higher level of anxiety when following the news and stories related to COVID-19 on TV, media, or social networks. One third of dentists mentioned that they had treated exclusively specific urgent dental problems since the onset of the pandemic and more than 13.3% declared that they refused to provide medical assistance to some specific pathologies because of the fear of infection. The results reflect new challenges and rules adopted by dentists in order to diminish the risk of infection and the impact of pandemic considering their psychological, familial, and financial context. Policymakers and professional associations around may benefit from these findings while formulating guidelines to support dentists during COVID-19 or any future pandemics.

The Psychological Impact of the Coronavirus Disease 2019 Pandemic on Pregnant Women in China

Background: The coronavirus disease 2019 (COVID-19) pandemic has been reported to have negative psychological impact on mental health. Nonetheless, there are few studies investigating the impacts on pregnant women. This study investigated the psychological impact of COVID-19 pandemic on pregnant women, and the associated risk factors that moderated this impact. Methods and Materials: A total of 2,798 pregnant participants were recruited from the Guangzhou Women and Children's Medical Center. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) and Insomnia Severity Index (ISI) were used to assess depression, generalized anxiety disorder and insomnia, respectively, during and before the COVID-19 pandemic. The Impact of Event Scale-Revised (IES-R) was used to assess psychological stress during the COVID-19 pandemic. Results: During the COVID-19 pandemic, over one third of pregnant participants reported mild depression, around 20% experienced mild generalized anxiety, about one third reported problems with sleeping, and more than 15% felt mild psychological stress. The occurrence of psychological problems was significantly higher during the COVID-19 pandemic when compared to before the outbreak. The previously described pattern that pregnant women in the first trimester are more likely to report depression, and those in the third trimester are more likely to report insomnia and psychological stress, was also recognized in our study population. Mental health issues existing before the outbreak were risk factors, while family support was a protective factor in the occurrence of the measured mental health problems during the COVID-19 pandemic. Conclusion: Our data suggest pregnant women's mental health is inevitably affected during the COVID-19 pandemic. Pregnant women in the first and third trimester and those who experienced mental issues before the outbreak may be particularly affected.